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Query: UMLS:C0036341 (
schizophrenia
)
60,220
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Following 6 years of continuous chlorpromazine therapy for
schizophrenia
, a young woman developed multifocal tics and vocalizations characteristic of
Tourette syndrome
. The symptoms first appeared when chlorpromazine was withdrawn. They were permanent, although partially ameliorated by chronic haloperidol therapy. Because of her age and past history, these symptoms were attributed to chronic neuroleptic therapy analogous to neuroleptic-induced tardive dyskinesia, rather than to
Tourette syndrome
per se. These symptoms suggest that chronic receptor-site blockade can result in hypersensitivity of dopamine receptor sites, and that this may play a role in the pathophysiology of
Gilles de la Tourette syndrome
. This is the first evidence that hypersensitivity of dopamine receptors is involved in the pathophysiology of
Tourette syndrome
.
...
PMID:Gilles de la Tourette syndrome after long-term chlorpromazine therapy. 28 1
Alpha rhythm is classically described as a bilateral posterior rhythm of substantially constant frequency in the range of 8-13 Hz which is enhanced by mental relaxation and blocked by attention. Since the full expression of alpha rhythm has been shown to occur coincident with puberty, it is possible that the establishment of alpha rhythm is subject to neuroendocrine influences which govern psychosexual maturation. There is ample evidence to indicate that the pineal gland is implicated in cerebral maturation and psychosexual development. Nocturnal plasma melatonin levels have been shown to decline progressively throughout childhood reaching a nadir at puberty. Since administration of melatonin has been reported to block alpha rhythm, it is proposed that the progressive decline in melatonin secretion during childhood facilitates the maturation of the alpha rhythm. Consequently, the presence of alpha rhythm could be used as a neurophysiological marker for the activity of the pineal gland and disorders associated with absent or delayed maturation of the alpha rhythm such as autism, dyslexia, personality disorders, epilepsy,
Tourette's syndrome
, and
schizophrenia
might be related to disturbances of pineal melatonin functions in early life. Moreover, since the EEG patterns associated with cerebral immaturity (i.e., slowing, absence of alpha activity) are more pronounced in the left hemisphere, this hypothesis implies differential influence of the pineal gland on hemispheric maturation potentially accounting for the vulnerability of the left hemisphere to cerebral insults.
...
PMID:Alpha rhythm and the pineal gland. 130 57
Animal data indicate that serotonin (5-HT) is a major neurotransmitter involved in the control of numerous central nervous system functions including mood, aggression, pain, anxiety, sleep, memory, eating behavior, addictive behavior, temperature control, endocrine regulation, and motor behavior. Moreover, there is evidence that abnormalities of 5-HT functions are related to the pathophysiology of diverse neurological conditions including Parkinson's disease, tardive dyskinesia, akathisia, dystonia, Huntington's disease, familial tremor, restless legs syndrome, myoclonus,
Gilles de la Tourette's syndrome
, multiple sclerosis, sleep disorders, and dementia. The psychiatric disorders of
schizophrenia
, mania, depression, aggressive and self-injurious behavior, obsessive compulsive disorder, seasonal affective disorder, substance abuse, hypersexuality, anxiety disorders, bulimia, childhood hyperactivity, and behavioral disorders in geriatric patients have been linked to impaired central 5-HT functions. Tryptophan, the natural amino acid precursor in 5-HT biosynthesis, increases 5-HT synthesis in the brain and, therefore, may stimulate 5-HT release and function. Since it is a natural constituent of the diet, tryptophan should have low toxicity and produce few side effects. Based on these advantages, dietary tryptophan supplementation has been used in the management of neuropsychiatric disorders with variable success. This review summarizes current clinical use of tryptophan supplementation in neuropsychiatric disorders.
...
PMID:L-tryptophan in neuropsychiatric disorders: a review. 130 30
We have had experience in treating tardive
Tourette
-like syndrome on a chronic schizophrenic patient. The patient was a 38-year-old woman. A diagnosis of
schizophrenia
was made in 1971 and she received repeated medications for 17 years. In 1989, she began to show vocal tic with coprolalia and motor tic. The medications were haloperidol 18 mg, zotepine 200 mg, levomepromazine 100 mg, biperiden 3 mg and nitrazepam 10 mg at the beginning of
Tourette
-like syndrome. We have tried to change the medications but this tardive
Tourette
-like syndrome continued to hang on. However, the symptoms gradually improved after a change in drugs; cessation of biperiden 3 mg and the administration of clonazepam 3 mg. The present case suggested that tardive
Tourette
-like syndrome might be a subtype of neuroleptic-associated tardive syndromes which might be treated with clonazepam.
...
PMID:A case of tardive Tourette-like syndrome. 135 27
In the past 5 years, we have witnessed the continuation of important trends in clinical research that began earlier in the decade. With regard to the treatment of specific disorders in children and adolescents, the most significant developments have been the examination of the tricyclics for the treatment of depression and the initiation of controlled studies for the treatment of
Tourette syndrome
. Unfortunately, the findings from the depression studies have been uniformly negative, and the results of research on both depression and tic disorders show a relatively high rate of placebo responsivity, which raises nagging questions about the role of case reports and open trials. Another important trend in pediatric psychopharmacotherapy is the search for substitutes for the neuroleptics. Potential candidates include agents such as lithium, naltrexone, fenfluramine, clonidine, and carbamazepine. The most underresearched disorders are a combination of the least common (e.g.
schizophrenia
, mania) and those that are apparently perceived as less serious (e.g. sleep disorders, certain anxiety disorders). Not surprisingly, the most studied disorder and treatment is hyperactivity and stimulant medication, respectively. Considerable progress has been made in understanding the social implications of the associated symptoms and their response to stimulant drugs, aided greatly by the use of direct observation procedures. Researchers are beginning to attend to the implications of comorbidity for assessing response to medication. There has been additional confirmation of efficacy of stimulant treatment for preschoolers and adolescents. Dose-response issues remain to some extent unresolved, the primary impediments being interpretive misconceptions associated with trend analysis, an overreliance on the syndromal perspective and too little attention to target behaviors and their clinical implications, and the failure to operationalize the minimal effective dose with regard to the normalization and supranormalization of target and collateral behaviors. Disagreement over whether hyperactivity is a learning or a behavior disorder (or both) and what academic underproductivity means clinically and socially is also impeding progress. With regard to developmental disorders, controlled studies indicate that fenfluramine and naltrexone are effective for managing associated symptoms in some individuals. However, given the limited amount of research on these agents, their status as clinically useful palliatives must be considered tentative.(ABSTRACT TRUNCATED AT 400 WORDS)
...
PMID:Pediatric psychopharmacotherapy: a review of recent research. 137 Nov 22
This study examined the linkage between elevated blood serotonin in autism and the presence of circulating autoantibodies against the serotonin 5HT1A receptor. Information was also obtained on the diagnostic and receptor specificity of these autoantibodies. Blood serotonin was measured as was inhibition of serotonin binding to human cortical membranes by antibody-rich fractions of blood from controls and from patients with childhood autism,
schizophrenia
, obsessive-compulsive disorder,
Tourette
's, and multiple sclerosis. The results showed elevated blood serotonin was not closely related to inhibition of serotonin binding by antibody-rich blood fractions. Inhibition of binding was highest for patients with multiple sclerosis and was not specific to the 5HT1A receptor as currently defined. Although inhibition was not specific to autism, the data were insufficient to establish if people with autism differed from normal controls on this measure.
...
PMID:Hyperserotoninemia and antiserotonin antibodies in autism and other disorders. 137 97
It is currently thought that genetic predisposition to imbalances in dopaminergic transmission may underlie several neurological disorders, including
schizophrenia
, manic depression,
Tourette syndrome
, Parkinson disease, Huntington disease, and alcohol abuse. Originally two receptors, D1 and D2, were thought to account for all of the pharmacological actions of dopamine. However, through homology screening three additional genes, D3, D4, and D5, and two pseudogenes closely related to D5 have been characterized. To begin our genomic and evolutionary analyses of the human D5 dopamine receptor gene and its two pseudogenes, we have mapped each of them to their respective chromosomes. By combining in situ hybridization results with sequence analysis of PCR products from microdissected chromosomes, somatic cell hybrids, and radiation hybrids, we have assigned DRD5 (the locus containing the functional human D5 receptor gene) to chromosome 4p16.1, DRD5P1 (the locus containing D5 pseudogene 1) to chromosome 2p11.1-p11.2, and DRD5P2 (the locus of D5 pseudogene 2) to chromosome 1q21.1.
...
PMID:Chromosomal localization of three human D5 dopamine receptor genes. 138 8
Obsessive compulsive disorder is now recognized as a common psychiatric disorder. The lifetime prevalence of 2% to 3% found in the United States has also been found in epidemiologic studies in several other countries with diverse cultures. This disorder has previously been underestimated due to a number of factors that include patients' reluctance to spontaneously admit to obsessions and compulsions and the omission of screening questions about obsessive compulsive disorder on routine mental status examinations. Depression and other anxiety disorders frequently co-occur with obsessive compulsive disorder, which may contribute to misdiagnosis. Patients with eating disorders,
Gilles de la Tourette's syndrome
, and
schizophrenia
have a greater comorbid risk compared with the general population. Differential diagnosis of obsessive compulsive disorder includes generalized anxiety disorder, panic disorder, phobias, compulsive personality disorder, and hypochondriasis. While many of these syndromes are characterized by intrusive thoughts, few have associated rituals. The complex tics seen in some patients with
Tourette's syndrome
may be difficult to distinguish from the compulsions seen in obsessive compulsive disorder, and, in fact, there is significant overlap in symptoms between the two disorders. Currently, the impulse control disorders, such as compulsive gambling and the paraphilias, are not considered to be part of obsessive compulsive disorder. Although the phenomenology of obsessive compulsive disorder appears to be quite diverse, with many distinct kinds of obsessions and compulsions, there are three important core features: abnormal risk assessment, pathologic doubt, and incompleteness. These features cut across phenomenological subtypes and may be useful in defining homogeneous subgroups with distinct treatment outcomes.
...
PMID:The epidemiology and differential diagnosis of obsessive compulsive disorder. 156 54
A study was made of hereditary loading of probands with
Gilles de la Tourette's syndrome
(
GTS
) and of the degree of genetic homogeneity of the clinical varieties of the disturbance. Among 131 relatives of the patients,
GTS
was encountered in 1.52% of cases, whereas tics in 8.3% on the whole. It turned out as a result of a genetico-statistical analysis of different varieties of
GTS
that the excitable and inhibited subtypes of the typical
Tourette's syndrome
are homogeneous in terms of their hereditary loading and significantly differ (p greater than 0.05) from
schizophrenia
with
Tourette
-like disorders in the pathology of the schizophrenic spectrum (
schizophrenia
, schizoid psychopathy).
Schizophrenia
with
Tourette
-like disorders is genetically similar to sluggish
schizophrenia
of childhood (p = 0.95). In homogeneous hereditary predisposition to hyperkineses, their clinical diversity is determined both by the ground which gives rise to their development and by contribution of environmental factors.
...
PMID:[Familial background of patients with Gilles de la Tourette's disease]. 166 17
EEG mapping was used to study the ECG and brain electric activity in 45 normal children and in 33 patients with
Gilles de la Tourette's syndrome
. Significant differences were discovered in the test parameters in groups of patients and normal children as well as in subgroups of patients with different varieties of the syndrome. Analysis of the ECG has shown that 78% of children with typical
Tourette's syndrome
manifest neurovegetative regulation impairment in the form of bradycardia and cardiac arrhythmia. In tourette-like disorders within the framework of
schizophrenia
and encephalopathy and in normal test subjects, such alterations occur much more seldom. The data of the EEG mapping and analysis of spectral power of different rhythmic ranges attest to the existence of mainly nonspecific changes in the EEG common to all varieties of the syndrome. At the same time a tendency was recorded toward definite abnormalities in one or another patients' group. The data obtained can be of help for differential diagnosis of the syndrome under study.
...
PMID:[Various neurophysiological aspects of examination of children with Gilles de la Tourette's syndrome]. 166 18
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